Construction of Evidence Body for Revision of Safety Information on Package Inserts of Chinese Patent Medicines in Post-marketing： Taking Xiaoke'an Capsules as an Example / 中国实验方剂学杂志

ObjectiveTo construct the evidence body for revision of safety information on package inserts of Chinese patent medicines in post-marketing by taking Xiaoke'an capsules as an example， so as to provide reference for the revision of instructions of Chinese patent medicines in post-marketing. MethodThe construction of the evidence body was guided by the theory of traditional Chinese medicine（TCM） and the Technical Guiding Principles for Revision of Safety Information Items in Instructions for TCMs After Marketing， and 8 categories and 25 specific items were taken as the main body of the evidence body， and information inclusion， integration， screening and improvement were carried out， then expert demonstrations were conducted， and finally modifications were made based on the opinions of the Center for Drug Evaluation to complete the revision of the safety information in the instructions of Xiaoke'an capsules. Result［Adverse reactions］ of Xiaoke'an capsules was revised to "monitoring data show that the following adverse reactions can be seen with this product：individual hypoglycemic reaction reports". ［Contraindications］ was revised to "contraindicated for those allergic to this product and its ingredients". ［Precautions］ was revised to "（1）pregnant women should use with caution， （2）elderly people should consult a physician， （3）people with spleen deficiency and dampness， spleen and stomach deficiency and cold， or those who eat less and have diarrhea should use with caution， （4）this product contains ginseng， should not be taken at the same time with TCM prescriptions or patent medicines containing veratrum and Wulingzhi， （5）pay attention to monitoring blood sugar during medication， （6）if any other discomfort occurs during medication， you should seek medical attention in time". The warning was revised to "use with caution by pregnant women， and pay attention to regular monitoring of blood sugar". ConclusionIn accordance with the content and process of the evidence body for the revision of safety information in the instructions， the revision of the safety information in the instructions of Xiaoke'an capsules has been completed， providing a strong basis for the rational and safe use of medication in the clinic.

Improvement of cognitive function by escitalopram and paroxetine in patients with first-episode depressive disorder and its relationship with thyroid hormone levels / 四川精神卫生

BackgroundThe incidence of cognitive impairment in patients with depressive disorder is high， and the causes and mechanisms of which deserve more attention. It is usual that the thyroid hormone levels in patients with depressive disorder alter. Further research is needed to explore whether the cognitive function changes in patients with depressive disorder are related to thyroid hormone levels. ObjectiveTo explore the improvement of cognitive function in patients with first-episode depressive disorder after escitalopram and paroxetine treatment， and to analyse its correlation with thyroid hormone levels， so as to look for potential biomarkers of cognitive function change in patients with depressive disorder. MethodsFrom March 2021 to March 2022， 120 patients who met the diagnostic criteria of the International Classification of Diseases， tenth edition （ICD-10） for depression and were hospitalized at Shandong Mental Health Center were selected as the research objects. They were randomly divided into two groups by random number table method with 60 patients in each group. The two groups were treated with escitalopram （starting dose 5 mg/d） and paroxetine （starting dose 20 mg/d） for 6 weeks. Before and 6 weeks after the treatment， levels of thyroid stimulating hormone （TSH）， free thyroxine （FT4） and free triiodothyronine （FT3） were tested respectively. Depression degree and cognitive function level were assessed using the Hamilton Depression Scale-17 item （HAMD-17） and Montreal Cognitive Assessment （MoCA）， respectively. Pearson or Spearman correlation analysis was used to examine the correlation between the MoCA score difference before and after the treatment and the post-treatment level of thyroid hormone. ResultsBefore and 6 weeks after the treatment， the time effect of HAMD-17 total score in both groups was statistically significant （F=1 236.568， P<0.01）. Also， the time effect， group effect as well as interaction effect of time and group of MoCA total score in both groups were statistically significant （F=79.186， 6.026， 20.417， P<0.05 or 0.01）. The time effect， group effect as well as the interaction effect of time and group for FT3 level and FT4 level were statistically significant in both groups （F=75.973， 20.287， 0.961， 84.194， 0.142， 8.299， P<0.05 or 0.01）. According to the simple effect analysis. After the treatment， the MoCA total score in both groups was higher than that before treatment， while FT3 and FT4 levels were lower than those before treatment （F=15.864， 5.421， 8.524， 6.443， 7.628， 3.639， P<0.01）. After the 6-week treatment， the MoCA total score as well as FT3 and FT4 level differences in escitalopram and paroxetine groups were of statistical significance （t=5.841， -0.705， -2.349， P<0.05 or 0.01）. The MoCA score difference before and after treatment in paroxetine group was positively correlated with FT3 and FT4 levels after treatment （r=0.276， 0.382， P<0.05 or 0.01）. ConclusionBoth escitalopram and paroxetine can improve cognitive function in patients with first-episode depressive disorder. The improvement may be related to the changes in serum FT3 and FT4 levels.

Clinical Comprehensive Evaluation of Jintiange Capsules in Treatment of Osteoporosis / 中国实验方剂学杂志

ObjectiveTo comprehensively evaluate the clinical value of Jintiange Capsules （JCs） in the treatment of osteoporosis （OP） and clarify the intrinsic advantages and clinical treatment characteristics of JCs， providing references for relevant departments of national health and medicine decision-making and the basis and clues for clinical and basic in-depth research. MethodBased on evidence-based medical evidence， this study integrated quantitative and qualitative methods and combined with questionnaires， official website data， human experience， pharmacoeconomic evaluation， and other research methods. From the effectiveness， safety， economy， innovation， suitability， accessibility， and traditional Chinese medicine （TCM） characteristics of the '6+1' dimension， the clinical evidence and value of JCs in the treatment of OP were comprehensively evaluated， forming the 'clinical evidence and value evaluation index'. The comprehensive evaluation of clinical value was based on the multi-criteria decision analysis framework. The expert meeting method was used to empower each dimension and value index. The clinical evidence and value evaluation software of Chinese patent medicine （CSC v2.0） was used to calculate the total value score， and the clinical advantages of JCs were comprehensively evaluated. ResultBased on randomized controlled clinical studies and systematic review， data analysis of spontaneous reporting system （SRS）， case reports， non-clinical safety studies， etc.， serious adverse drug reactions （ADRs） were reported after the launch of this product monitored by SRS， mainly involving abnormal liver function and adverse reactions of cardiovascular system. Therefore， the safety evidence adequacy of this product should be further improved， and the safety evaluation was Grade B. Meta-analysis showed that JCs were superior to the control group in improving the total clinical effective rate， improving bone mineral density， reducing visual analogue scale （VAS） score， and shortening fracture healing time. Combined with Grading of Recommendations Assessment， Development and Evaluation （GRADE） evidence evaluation， the comprehensive evaluation of effectiveness was Grade A. Pharmacoeconomic evaluation showed that JCs combined with calcium carbonate D3 tablets were more cost-effective than calcium carbonate D3 tablets alone in patients with OP. Compared with Gushukang capsules， JCs had more cost-effectiveness advantages， but the sample size included in the study was small， and the results needed to be verified by further studies. Combined with the results of the Comparative Assessment of Structure Prediction （CASP） evaluation list， the comprehensive economic evaluation was Grade B. JCs were the only bionic medicine of tiger bone in China with all intellectual property rights， with 3 national invention patents. Its process preparation and fingerprint detection had obvious technical advantages. It had innovative advantages in the supply base equipment， medicine resource management， production technology， and other aspects. Thus， its innovative comprehensive evaluation was Grade A. JCs were in capsule dosage form， which was relatively convenient for storage and transportation. The dosage form was suitable for indications， and the usage was easy for patients to grasp and accept. The statutory information and non-statutory information met the national standards. The comprehensive evaluation of suitability was Grade A. JCs did not contain toxic ingredients， had no restrictions on origin and prescription， and had abundant resources of original medicinal materials. The affordability of JCs in the treatment of OP was good in urban areas （14.97%） but not in rural areas （39.76%）. The price was higher than that of similar Chinese patent medicines， and the comprehensive evaluation of availability was Grade B. JCs had a reasonable proportion of natural animal bones， and their composition was basically the same as that of natural tiger bones. After marketing， more than 2 000 cases of real-world clinical research evidence was accumulated， and the comprehensive evaluation of TCM characteristics was Grade B. CSC v2.0 software was used for quantitative synthesis of the '6+1' dimension， and the comprehensive clinical value of JCs in the treatment of OP was Grade A. ConclusionJCs have good clinical value in the treatment of OP， and the TCM characteristics are prominent. It is suggested that JCs can be directly transformed into the related policy results of basic clinical drug management according to procedures.

Polygalacin D inhibits the growth of hepatocellular carcinoma cells through BNIP3L-mediated mitophagy and endogenous apoptosis pathways / 中国天然药物

Platycodon grandiflorum (Jacq.) A. DC. is a famous medicinal plant commonly used in East Asia. Triterpene saponins isolated from P. grandiflorum are the main biologically active compounds, among which polygalacin D (PGD) has been reported to be an anti-tumor agent. However, its anti-tumor mechanism against hepatocellular carcinoma is unknown. This study aimed to explore the inhibitory effect of PGD in hepatocellular carcinoma cells and related mechanisms of action. We found that PGD exerted significant inhibitory effect on hepatocellular carcinoma cells through apoptosis and autophagy. Analysis of the expression of apoptosis-related proteins and autophagy-related proteins revealed that this phenomenon was attributed to the mitochondrial apoptosis and mitophagy pathways. Subsequently, using specific inhibitors, we found that apoptosis and autophagy had mutually reinforcing effects. In addition, further analysis of autophagy showed that PGD induced mitophagy by increasing BCL2 interacting protein 3 like (BNIP3L) levels.In vivo experiments demonstrated that PGD significantly inhibited tumor growth and increased the levels of apoptosis and autophagy in tumors. Overall, our findings showed that PGD induced cell death of hepatocellular carcinoma cells primarily through mitochondrial apoptosis and mitophagy pathways. Therefore, PGD can be used as an apoptosis and autophagy agonist in the research and development of antitumor agents.

Sleeve gastrectomy and simultaneous repair of hiatal hernia for prevention of gastroesophageal reflux / 中华普通外科杂志

Objective:To evaluate the laparoscopic sleeve gastrectomy combined with hiatal hernia repair surgery for weight loss and antireflux.Methods:This study included 21 obese patients with gastroesophageal reflux who underwent laparoscopic sleeve gastrectomy at the Weight Loss Metabolism Center of the Department of Hepatobiliary and Pancreatic Surgery of Zhejiang Provincial People's Hospital from Dec 2019 to Dec 2020. Patients were divided into simple bariatric surgery group (9 cases) and simultaneous combined surgery group (12 cases).Results:In the combined surgery group, 1 case had postoperative gastric leakage. The postoperative body weight, waist circumference, and BMI indexes of the two groups showed a downward trend ( F=5.154, P=0.013; F=14.319, P<0.001; F=6.725, P=0.004). There was a statistically significant difference in the excess weight loss in both the two groups at 6 months after the operation compared to 1 month after the operation ( t=8.927, P<0.001; t=8.926, P<0.001). There was no statistically significant difference in postoperative lower esophageal sphincter resting pressure and Gerd symptom score in the bariatric surgery group compared with preoperative ( t=-0.891, P=0.507; t=0.629, P=0.298). The postoperative Gerd symptom score of the patients in the combined surgery group was significantly lower than that before the operation, and the resting pressure of the lower esophageal sphincter was significantly higher than that before the operation, ( t=-10.539, P<0.001; t=5.066, P=0.038). Conclusion:Combined surgery have the same weight loss effect as in simple bariatric surgery in obese patients with gastroesophageal reflux, in addition to stronger anti-reflux effect.

Laparoscopic splenectomy and pericardial devascularization with artery pressure perfusion / 中国医师杂志

Objective:To evaluate trans-artery pressure perfusion autologous transfusion for laparoscopic splenectomy and pericardial devascularization (LSPD).Methods:The clinical data of patients with laparoscopic splenectomy in Zhejiang Provincial People′s Hospital in recent 3 years were reviewed. The therapeutic effects of 30 LSPD cases with trans-artery pressure perfusion (observation group) and 30 radical LSPD cases (control group) were compared and analyzed.Results:There was no significant difference in age, sex, preoperative liver function grade and spleen volume between the two groups ( P>0.05). All 60 patients completed laparoscopic splenectomy without conversion to laparotomy or death. There was no significant difference in liver function, operation time and intraoperative bleeding between the observation group and the control group ( P>0.05), and there was also no significant difference in blood transfusion, postoperative complications and hospital stay ( P>0.05). The hemoglobin level in the observation group was significantly higher than that in the control group ( P<0.05). Conclusions:Laparoscopic splenectomy and pericardial devascularization with trans-artery pressure perfusion autologous transfusion can increase post-operative hemoglobin value effectively.

Astragaloside IV suppresses post-ischemic natural killer cell infiltration and activation in the brain: involvement of histone deacetylase inhibition / 医学前沿

Natural killer (NK) cells, a type of cytotoxic lymphocytes, can infiltrate into ischemic brain and exacerbate neuronal cell death. Astragaloside IV (ASIV) is the major bioactive ingredient of Astragalus membranaceus, a Chinese herbal medicine, and possesses potent immunomodulatory and neuroprotective properties. This study investigated the effects of ASIV on post-ischemic brain infiltration and activation of NK cells. ASIV reduced brain infarction and alleviated functional deficits in MCAO rats, and these beneficial effects persisted for at least 7 days. Abundant NK cells infiltrated into the ischemic hemisphere on day 1 after brain ischemia, and this infiltration was suppressed by ASIV. Strikingly, ASIV reversed NK cell deficiency in the spleen and blood after brain ischemia. ASIV inhibited astrocyte-derived CCL2 upregulation and reduced CCR2

2-Aminobenzenethiol-Functionalized Silver-Decorated Nanoporous Silicon Photoelectrodes for Selective CO2 Reduction.

A molecularly thin layer of 2-aminobenzenethiol (2-ABT) was adsorbed onto nanoporous p-type silicon (b-Si) photocathodes decorated with Ag nanoparticles (Ag NPs). The addition of 2-ABT alters the balance of the CO2 reduction and hydrogen evolution reactions, resulting in more selective and efficient reduction of CO2 to CO. The 2-ABT adsorbate layer was characterized by Fourier transform infrared (FTIR) spectroscopy and modeled by density functional theory calculations. Ex situ X-ray photoelectron spectroscopy (XPS) of the 2-ABT modified electrodes suggests that surface Ag atoms are in the +1 oxidation state and coordinated to 2-ABT via Ag-S bonds. Under visible light illumination, the onset potential for CO2 reduction was -50 mV vs. RHE, an anodic shift of about 150 mV relative to a sample without 2-ABT. The adsorption of 2-ABT lowers the overpotentials for both CO2 reduction and hydrogen evolution. A comparison of electrodes functionalized with different aromatic thiols and amines suggests that the primary role of the thiol group in 2-ABT is to anchor the NH2 group near the Ag surface, where it serves to bind CO2 and also to assist in proton transfer.

Laparoscopic hiatal hernia repair plus fundoplication for gastroesophageal reflux disease: report of 206 cases / 中华普通外科杂志

Objective:To evaluate the effect of laparoscopic hiatal hernia repair plus fundoplication on gastroesophageal reflux disease (GERD).Methods:The clinical data of 206 GERD patients with esophageal hiatal hernia treated by laparoscopic esophageal hiatal hernia repair + fundoplication at the gastroesophageal reflux center of Zhejiang People′s Hospital from Jan 2016 to Jun 2019 was retrospectively analyzed, including basic data, symptom score, auxiliary examination and follow-up.Results:All 206 patients underwent laparoscopic anti-reflux surgery successfully. There was no conversion to open surgery and no death. Preoperative Deemester scores were 46.49±37.42, while Deemester score 6 month after surgery were 6.38±4.69.Mean follow-up time was 15 months and good result were achieved in 98% of follow-up cases.Conclusion:Laparoscopic repair plus fundoplication for GERD is of minimally invasive and satisfactory, while the preoperative evaluation of surgical indications is properly conducted.

Evaluation of therapeutic effect of Salviae Miltiorrhizae and Ligustrazine Hydrochloride injection on coronary atherosclerotic heart disease by using propensity scores / 国际中医中药杂志

Objective:To evaluate the clinical effect of Salviae Miltiorrhizae and Ligustrazine Hydrochloride injection on coronary heart disease in real world.Methods:Took the patients data with coronary heart disease of 24 tertiary-class A hospitals’ information system from October 2006 to December 2015 as the research targets. The patients injected by Salviae Miltiorrhizae and Ligustrazine Hydrochloride injection were selected as the observation group, and who were not injected were selected as the control group with ratio of 1:1, the same number on gender, similar age (+5 years difference) and similar condition upon hospitalization. Taking medication efficacy as the outcome evaluation index, the 30 confounding factors in this study were controlled by propensity scores, including hospital admission, co-morbidity, co-medication, occupation, cost category, and total hospitalization costs. Comparative analysis of the effect of Salviae Miltiorrhizae and Ligustrazine Hydrochloride injection on the clinical outcome of coronary heart disease by classical logistic regression and logistic regression weighted by propensity score.Results:30 confounding factors were identified and balanced, and 7 confounding factors were most affected factors that included clopidogrel bisulfate tablets, occupation, inosine tablets, levocarnidine injection, cerebroprotein hydrolysate injection, nitroglycerin and insulin. Both methods of logistic regression demonstrated that patients receiving parenterally administered Salviae Miltiorrhizae and Ligustrazine Hydrochloride injection had improved outcomes compared to those who did not receive the drug ( P<0.05). Conclusions:The study suggestes that the Salviae Miltiorrhizae and Ligustrazine Hydrochloride injection is a potential advantageous therapy in the treatment of coronary heart disease. However, a large amount of unknown confounding variable should be taken into account. Consider this research is a retrospective study, and the results need to be further verified by prospective studies.

Relation between blood glucose and the prognosis of severe coronavirus disease 2019 / 中南大学学报(医学版)

OBJECTIVES@#To describe the clinical characteristics and outcomes of severely ill patients with coronavirus disease 2019, and to investigate the relationship between plasma glucose level and the prognosis of severely ill patients with coronavirus disease 2019.@*METHODS@#We enrolled 52 severely ill patients with coronavirus disease 2019. Among them, 12 cases progressed to critical illness. The clinical and biochemical characteristics of severely and critically ill patients were compared.@*RESULTS@#Compared with the severely ill patients, critically ill patients had higher white blood cell and neutrophil counts, as well as higher levels of -dimer, IL-6 and C-reactive protein (all <0.05). Before treatment, the fasting plasma glucose (FPG) levels were significantly higher in the critically ill patient's group [(10.23±3.71) mmol/L] compared to those in the severely ill patients [(7.12±3.35) mmol/L, <0.05]. After adjusting for age, gender, and course of the disease, fasting blood glucose at admission (OR=1.308, 95% CI 1.066 to 1.606, =0.01) and hyperglycemia at admission (OR=29.198, 95% CI 2.903 to 293.639, =0.004) were closely related to whether severely ill patients progressed to critical patients with coronavirus disease 2019. In our study, 15 (34.8%) of the severely ill and 10 (83.3%) critically ill patients received the steroid treatment. Compared with the severely ill patients, the FPG levels in critically ill patients were higher (<0.05).@*CONCLUSIONS@#Fasting hyperglycemia at admission is a significant predictor for the prognosis of severely ill patients with coronavirus disease 2019. Closely monitoring and the optimal management of hyperglycemia may improve the prognosis of patients with coronavirus disease 2019.

Formation of gap junctions between adipose stem cells-derived Schwann cells in a rat model of dyskinesia induced by brain injury / 南方医科大学学报

OBJECTIVE@#To investigate the formation of gap junctions between Schwann cells derived from differentiated adipose stem cells implanted in a rat model of dyskinesia induced by brain injury and its positive effect in promoting functional recovery of the rats.@*METHODS@#In a rat model of hemiplegia induced by motor cortex injury, adipose stem cells or Schwann cells differentiated from adipose stem cells, either with or without RNAi-mediated silencing of Cx43, were transplanted orthotopically in the lesion. The recovery of the motor function of the rats was observed and scored after the transplantation. Rat brain tissues were sampled to detect the expressions of nerve growth factor (NGF) using Western blotting and RT-PCR.@*RESULTS@#All the 3 cell transplantation therapies obviously improved the motor function scores of the rats as compared with the control rats. The expression of NGF in the brain tissue was significantly lower in the control group than in the cell transplantation groups. NGF expression in the brain tissues of rats receiving transplantation of Schwann cells with Cx43 gene silencing was lower than that in rats receiving Schwann cells without Cx43 silencing, and was similar with that in rats transplanted with adipose stem cells. The results of RT-PCR showed that NGF mRNA level in the control group was significantly lower than that in the other 3 groups. NGF mRNA expression was the highest in Schwann cell group without Cx43 silencing, followed by adipose stem cell group, and then by Schwann cell group with Cx43 silencing.@*CONCLUSIONS@#In the rat model of dyskinesia induced by brain injury, transplantations of adipose stem cells and adipose stem cells-derived Schwann cells both promote the functional recovery of brain damage, in which gap junction protein Cx43 plays an important role to promote functional gap junction formation possibly by enhancing NGF expression.

Pathogen distribution and drug resistance of biliary tract infection in patients with cholelithiasis / 中国生化药物杂志

Objective To investigate the pathogen distribution and drug resistance of biliary tract infection in patients with cholelithiasis, and to summarize the clinical experience.Methods160 patients with cholelithiasis were analyzed.The proportion of patients with biliary tract infection was counted.The bile and venous blood were collected and the distribution of pathogens was detected.The patients were also analyzed for the drug resistance.ResultsThe incidence of biliary tract infection was 62.5%, the positive rate of bile culture was 62.5%, and the positive rate of blood test was 37.5% for 160 patients with cholelithiasis.Gram-positive bacteria include Escherichia coli, Enterococcus faecium, Staphylococcus, Gram-negative bacteria, including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, etc.;Gram-positive bacteria for the large Methicillin and erythromycin resistance is higher, Gram-negative bacteria for ampicillin and levofloxacin higher resistance.ConclusionThe pathogen distribution and drug resistance of biliary tract infection in patients with cholelithiasis are analyzed.The clinical pathogens are widely distributed.At the same time, the pathogens have different resistance to different antimicrobial agents.Therefore, clinical use should be reasonable choice when using antimicrobial agents, With a view to give full play to drug effects.

Study on Academic Teams of TCM Treatment for Ulcerative Colitis Based on Literature / 中国中医药信息杂志

Objective To analyze the research directions and research status of main academic teams of TCM treatment for ulcerative colitis in the recent 15 years.Methods Articles about TCM treatment for ulcerative colitis from Jan. 2000 to Dec. 2015 in CNKI were searched. Articles were screened by inclusion and exclusion criteria, and then publication time and research institutes were under metrology analysis. According to Price Law and comprehensive indexes, core authors were indentified. The NetDraw2.118 social network was applied to establish author co-occurrence matrix, build core author relationship network and screen academic teams. Combined with typical articles, main research fields and research status of main academic teams were analyzed.Results3658 were included from 6365 articles. 33 core authors in the filed of TCM treatment for ulcerative colitis were identified, belonging to 5 academic teams with relatively higher academic influence: Wu Huangan team, Shenhong team, Wang Hongxia team, Liu Yihua team and Zhang Yansheng team. Each team proposed unique diagnosis and treatment methods.Conclusion Academic teams of TCM treatment for ulcerative colitis have inherited and promoted TCM theories and formed unique academic system in clinical practice and research.

Protective effect of Apelin-13 on focal cerebral ischemia-reperfusion injury in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the protective effect of Apelin-13 on focal cerebral ischemia-reperfusion injury in rats.</p><p><b>METHODS</b>Focal transient cerebral ischemia-reperfusion injury was induced in male SD rats using modified suture occlusion technique. The rats were randomly divided into 5 groups: Sham group, Model group, Apelin-low dose (A) group, Apelin-middle dose (B) group and Apelin-high dose (C) group. Apelin-13 was injected into lateral cerebral ventricle, and the neurological function score, brain edema, infarct volume, apoptosis, malondialdehyde (MDA), superoxide dismutase (SOD) and extracellular regulated kinase1/2 (ERK1/2) protein were measured.</p><p><b>RESULTS</b>Neurological function scores, percentage of brain water content, infarct volumes and TUNEL-positive cells in B and C groups were lower than those in Model group (P<0.05). The level of MDA in the tissue bomogenate of brain tissue in the surrounding area of ischemia of B and C groups was lower than that of Model group, while the activity of SOD was higher (P<0.05). There was no significant difference in ERK1/2 protein expression among the groups (P>0.05). P-ERK1/2 increased in Model group and A, B, and C groups compared with Sham group (P<0.05), and that of A, B, and C group was higher than that of Model group (P<0.05).</p><p><b>CONCLUSION</b>Apelin-13 may play an important role by inhibiting oxidative stress to protect against focal cerebral ischemia-reperfusion injury; ERK1/2 signaling pathway may be involved in the protective mechanism of Apelin-13.</p>

Effect of Consciousness-restoring Needling Combined with Comprehensive Rehabilitation Training on Motor Function and Activities of Daily Living of Poststroke Patients with Hemiplegia / 广州中医药大学学报

Objective To observe the therapeutic effect of consciousness-restoring needling combined with comprehensive rehabilitation training on motor function and the activities of daily living of poststroke patients with hemiplegia. Methods Sixty qualified patients were evenly randomized into observation group and control group. All of the patients were given conventional medicine treatment and conventional rehabilitation training, and the treatment group was given consciousness-restoring needling additionally. The therapeutic effects were compared at the end of first session of treatment for 4 weeks and 12 weeks after the first session of treatment. The Fugl-Meyer motor assessment scale (FMA), modified Barthel Index (MBI) and Stroke-Specific Quality of Life Scale ( SS-QQL) were taken as the main evaluation indexes. Results The differences of FMA, MBI and SS-QOL scores were insignificant between the two groups before treatment ( P>0.05). At the end of treatment for 4 weeks, FMA, MBI and SS-QOL scores were increased in the two groups (P<0.05), and the increase was more obvious in the observation group (P<0.05). The results of follow-up till the 12th week showed that FMA, MBI and SS-QOL scores were still higher than the baseline level ( P<0.05). Conclusion Consciousness-restoring needling combined with comprehensive rehabilitation training has better effect on improving motor function and the activities of daily living of poststroke hemiplegia patients than comprehensive rehabilitation training alone.

Operation Coordination for the da Vinci Robot Surgical System / 中国微创外科杂志

[Summary] This paper reported the surgical cooperation in 72 cases of da Vinci robot operations between September 2014 and December 2014 in this hospital .All the 72 cases of total laparoscopic operation by using the da Vinci robot assistance were successfully completed, without robot faults caused by mismatch and nursing complications caused by improper nursing .We believe that nurse training with robot surgical system and qualification certification , preoperative patient visits , reasonable arrangement of operation room , careful observation with skilled coordination with the robot , proper postoperative placement of the robot , and maintenance and disinfection of the machine are crucial to a successful surgery .

Total mesopancreas excision in radical resection of pancreatic head carcinoma / 中华普通外科杂志

Objective To evaluate the concept of artery first and total mesopancreatic excision in radical resection of pancreatic head carcinoma through both anterior and posterior approaches.Method The anterior approach was to identify the superior mesenteric artery (SMA) and the posterior approach to confirm the possibility of negative margin at the origin of SMA,on the posterio-lateral vascular wall of superior mesenteric vein (SMV) and the supposed posterior of the mesopancreas.The resection scope were with the celiac trunk and common hepatic artery as the upper boarder,the SMA as the left boarder,the inferior mesenteric vein (IMA) level as the lower boarder,to achieve a complete mesopancreatic excision,namely the en bloc resection of all the involved nerve,the lymph tissue and vascular tissue along the right side of the axial composed by SMA and celiac trunk.Results Of the 15 patients,11 had radical Whipple procedure,among which 2 had a combining SMV resection and reconstruction.1 case suffered from delayed gastric emptying and 2 cases from bile leakage.There was no mortality.The postoperative pathology reported carcinoma in all 11 cases,with duodenum and low bile duct involved in 4 cases,with the duodenum involved in 6 cases,no surrounding tissue involvement was identified in 1 case.Nerve involvement was found in 7 (7/11),vascular involvement in 10 (10/11),and lymphnode metastasis was (2.5 ± 3.8/12.9 ± 4.9).Conclusions The radical resection of pancreatic head carcinoma using the concept of artery first and the total mesopancreatic excision is helpful for an early evaluation of the possibility of radical resection and guarantees negative margins.

Pancreaticojejunostomy sleeve reconstruction after pancreaticoduodenectomy in laparoscopic and open surgery.

INTRODUCTION: Laparoscopic procedures for pancreatic surgery have been significantly improved recently; however, only a limited number of successful laparoscopic or laparoscopy-assisted pancreaticoduodenectomy (PD) have been reported. The limitations could be attributed to the complexity of the reconstruction procedures under laparoscopic observation and the high incidence of complications. Postoperative pancreatic fistula (POPF) has been regarded traditionally as the most frequent major complication and is a potentially serious and life-threatening event. It remains the single most important cause of morbidity after PD and contributes significantly to prolonged mortality. Several modified methods of pancreas anastomosis were introduced to prevent POPF. However, few methods with a satisfactory leakage rate have yet to be seen. Collating principle of theoretical mechanics, we introduce a new method of reconstruction by performing an asymmetric sleeving-joint pancreaticojejunostomy (SJPJ). The aim of this study is to summarize the results of a new technique that is designed to decrease the POPF. METHODS: From January 2004 to December 2010, SJPJ was performed on 86 patients undergoing PD by 1 surgeon: a laparoscopic reconstruction was completed in 9 cases, a hand-assisted laparoscopic reconstruction in 2 cases, and an open SJPJ reconstruction in 75 cases. DISCUSSION: We used SJPJ, an asymmetric pancreaticojejunostomy (PJ). The time of operation ranged from 300 minutes to 640 minutes. Postoperatively there were no major morbidities and no deaths. Although POPF was observed in the laparoscopic SJPJ group with pancreatic adenocarcinoma, 3 patients developed POPF in the open SJPJ group with ampullary adenocarcinoma (n=1) and pancreatic adenocarcinoma (n=2). The POPF rate was 9.30% in the open SJPJ group and 9.10% in the laparoscopic SJPJ group. The SJPJ procedure facilitates PJ, both laparoscopically and in open surgery. It is safe, effective, and feasible in experience hands.